Blake Dialysis LLC

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

BLAKE DIALYSIS LLC

Doing business as

Capitol Court Dialysis

Practice address

4176 N 56TH St
Milwaukee, WI 53216-1276

Phone

(414) 445-2119

Fax

(414) 445-3794

NPI assigned

Apr 10, 2013

Last updated

Mar 16, 2026By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Samuel T Wey

Title

VP Licensure & Certification

Phone

(615) 341-6641

Specialties & licenses 1

Addresses

Other names 1

• Capitol Court Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Blake Dialysis LLC

  dba Mill Street HomeTraining

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Cedarburg, WI
  • NPI 1497033229

  9537339585

  Same PAC ID

Listed as

DaVita Capitol Court DialysisCCN 522598

Overall star rating

3.0 of 5

Ownership

Profit

Certified

Apr 21, 2014

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

16

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Blake Dialysis LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Blake Dialysis LLC

  dba Mill Street HomeTraining

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Cedarburg, WI
  • NPI 1497033229
  NPD tax ID

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Total Renal Care Inc

  dba Kendall Kidney Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Miami, FL
  • NPI 1164748273

  Member Of

  NPD member

Locations

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Kamal Amin, M.D.

  • Nephrology Physician
  • Glendale, WI
  • NPI 1265406516

  Dialysis facility

  Care Compare affiliation Name & address match

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1365552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773619200000",
    "number": "1659714558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "L&C DEPT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4176 N 56TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532161276",
            "telephone_number": "414-445-2119",
            "fax_number": "414-445-3794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLAKE DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-10",
        "last_updated": "2026-03-16",
        "certification_date": "2026-03-16",
        "status": "A",
        "authorized_official_last_name": "WEY",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "VP LICENSURE & CERTIFICATION",
        "authorized_official_telephone_number": "615-341-6641"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Capitol Court Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Capitol Court Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Irina A Blagoeva, NP
• Adam Blaha
• Maureen T Blaha, APNP
• Katelyn Blair, MSW, CAPSW
• Sarah Blair, D.D.S.
• Francillya Blake
• Mark Francis Blake, M.D.
• Melinda A Blake, APSW
• Sharita Blakemore
• Olyver Jarrett Blakeway, LCSW

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.